Is There a Difference in Cost Between Standard and Virtual Surgical Planning for Orthognathic Surgery?

Abstract

Virtual surgical planning (VSP) and 3-dimensional printing of surgical splints are becoming the standard of care for orthognathic surgery, but costs have not been thoroughly evaluated. The purpose of this study was to compare the cost of VSP and 3-dimensional printing of splints ("VSP") versus that of 2-dimensional cephalometric evaluation, model surgery, and manual splint fabrication ("standard planning"). This is a retrospective cohort study including patients planned for bimaxillary surgery from January 2014 to January 2015 at Massachusetts General Hospital. Patients were divided into 3 groups by case type: symmetric, nonsegmental (group 1); asymmetric (group 2); and segmental (group 3). All cases underwent both VSP and standard planning with times for all activities recorded. The primary and secondary predictor variables were method of treatment planning and case type, respectively. Time-driven activity-based micro-costing analysis was used to quantify the differences in cost. Results were analyzed using a paired t test and analysis of variance. The sample included 43 patients (19 in group 1, 17 in group 2, and 7 in group 3). The average times and costs were 194 ± 14.1minutes and $2,765.94, respectively, for VSP and 540.9 ± 99.5minutes and $3,519.18, respectively, for standard planning. For the symmetric, nonsegmental group, the average times and costs were 188 ± 17.8minutes and $2,700.52, respectively, for VSP and 524.4 ± 86.1minutes and $3,380.17, respectively, for standard planning. For the asymmetric group, the average times and costs were 187.4 ± 10.9minutesand $2,713.69, respectively, for VSP and 556.1 ± 94.1minutes and $3,640.00, respectively, for standard planning. For the segmental group, the average times and costs were 208.8 ± 13.5minutes and $2,883.62, respectively, for VSP and 542.3 ± 118.4minutes and $3,537.37, respectively, for standard planning. All time and cost differences were statistically significant (P < .001). The results of this study indicate that VSP for bimaxillary orthognathic surgery takes significantlyless time and is less expensive than standard planning for the 3 types of cases analyzed.